Biomed. 

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SOUTH 

ERN  REGIONAL  LIBF 

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(ARY  FACILITY 
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4 

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THE  LIBRARY 

OF 

THE  UNIVERSITY 

OF  CALIFORNIA 

LOS  ANGELES 


RAPID  BREATHING 


AS   A 


PAIN    OBTUNDE^ 


MINOR  SURGERY,  OBSTETRICS, 


THE 


General'  Practice  of  Medicine 


AND   OF 


DENTISTRY. 


W.  G.  A    BONWILL,  D.D.S. 


VV  f 


RAPID  BREATHING  AS  A  PAIN  OBTUNDER 


MINOR  SURGERY,  OBSTETRICS,  THE  GENE 

RAL  PRACTICE  OF  MEDICINE  AND  OF 

DENTISTRY.* 

By  W.  G.   A.   Bonwii/l,   D.D.S. 

Through  the  kind  invitation  of  your  directors,  I  am 
present  to  give  you  the  history  of  "  rapid  breathing"  as  an 
analgesic  agent,  as  well  as  my  experience  therein  since  I  first 
discovered  it.  It  is  with  no  little  feeling  of  modesty  that  I 
appear  before  such  a  learned  and  honorable  body  of  physi- 
cians and  surgeons,  and  I  accept  the  privilege  as  a  high  com- 
pliment. I  trust  the  same  liberal  spirit  which  prompted  you 
to  call  this  subject  to  the  light  of  investigation  will  not  for- 
sake you  when  you  have  heard  all  I  have  to  say  and  you  sit 
in  judgment  thereon.  Sufficient  time  lias  now  elapsed  since 
the  first  promulgation  of  the  subject  for  the  shafts  of  ridi 
cade  to  be  well  nigh  spent  (which  is  the  common  logic  used 
to  crush  out  all  new  ideas),  and  it  is  to  be  expected  thai  gen- 
tlemen will  look  upon  it  with  all  the  charily  of  a  learned 
body,  and  not  be  too  hasty  to  condemn  what  they  have  had 
but  little  chance  to  investigate;  and.  of  course,  have  not 
practiced  with  that  success  which  can  only  come  from  an 
intelligent  understanding  of  its  application  and  mod  lis  ope- 
randi. 

Knowing  the  history  of  past  discoveries,  I  was  well  pre- 
pared for  the  crucible.  I  could  not  hope  to  be  an  exception. 
But,  so  far,  the  medical  profession  have  extended  me  more 
favor  than  I  have  received  at  the  hands  of  the  dental  profes- 
sion. 

My  first  conception  of  the  analgesic  property  of  a  pain  ob 
hinder  in  contradistinction  to  it<  anaesthetic  effect,  which 
finally  led  to  the  discovery  of  the  inhalation  of  common  air 
by  "rapid  breathing,"  was  in  1855,  while  performing  upon 
my  own  teeth  certain  operations  which  gave  mi'  intense 
pain,  and  I  could  not  afford  to  hurl  myself,  without  a  resort 
to  ether  and  chloroform.  These  agents  had  been  known  so 
short  a  time  that  no  one  was  specially  familiar  with  their 
action.  Without  knowing  whether  I  could  take  chloroform 
administered  by  myself,  and  at  the  same  time  perform  with 
skill  the  excavation  of  extremely  sensitive  dentine  or  tooth 
bone,  as  if  no  anaesthetic  had  been  taken,  and  not  he  con- 
scious of  pain,  was  more  than  the  experience  of  medical 
men  at  that  time  could  assure  mc  But,  having  a  love  for 
investigation  of  the  unknown,  I  prepared  myself  for  the 
ordeal.  By  degrees  I  took  the  chloroform  until  I  began  to 
feel  very  plainly  its  primary  effects,  and  knowing  that  I 
must  soon  be  unconscious.  I  applied  the  excavator  to  the 
carious  tooth,  and.  to  my  surprise,  found  no  pain  whatever, 
but  the  sense  of  touch  and  hearing  were  marvelously  intensi- 
fied. The  small  cavity  seemed  as  large  as  a  half  bushel;  the 
excavator  more  the  size  of  an  ax;  and  the  sound  was  equally 

*  Kead  before  the  Philadelphia  County  Medical  Society,  May  12.  fSSO. 
by  W.  G.  A.  Bon\viil,D.D.S..  Philadelphia. 

Published  in  the  Scientific  American  Supplement,  Xo.  27~>,  April  !).  1881. 


magnified.  That  I  might  not  he  mistaken.  I  repeated  t lie 
operation  until  1  was  confident  that  amestbetics  possessed  a 
power  not  hitherto  known — that  of  analgesia.  To  be  doubly 
certain,  I  gave  it  in  my  practice,  in  many  cases  with  the 
same  happy  results,  which  saved  me  from  the  risks  incident 
to  the  secondary  effects  of  an;e>thetics.  and  which  answered 
for  all  the  purposes  of  extracting  from  one  to  four  teeth. 
Not  satisfied  with  any  advance  longer  than  I  could  find  a 
better  plan,  1  experimented  with  the  galvanic  current  (to 
and  fro)  by  mi  applying  the  polo  that  I  substituted  a  stronger 
impression  by  electricity  from  the  nerve  centers  or  ganglia  to 
the  periphery  than  wa-  made  from  the  periphery  to  the 
brain.  This  wa-  so  much  of  a  success  that  1  threw  aside 
chloroform  and  el  her.  and  removed  the  living  nerve  <  if  a  tooth 
with  instruments  instead  of  using  ar-enic,  and  for  excavat- 
ing sensitive  caries  in  teeth,  preparatory  to  filling,  as  well 
as  many  teeth  extracted  by  it.  But  this  was  short-lived,  for 
it  led  to  another  step.  Sonietirn.es  I  would  inflict  severe  pain 
in  case-  of  congested  pulp-  or  from  it-  hasty  application,  or 
pu.-hing  it  to  do  loo  much,  when  my  patient  invariably 
would  draw  or  inhale  the  breath  very  forcibly  mid  r<ipir?!y. 
1  wa- struck  with  the  repeated  coincidence,  and  was  led  to 
exclaim:  "Nature's  amesthelic."  This  then  reminded  me 
of  boyhood's  bruises.  The  involuntary  action  of  every  one 
who  lias  a  finger  hurt  is  to  place  it  to  the  mouth  and  diaw 
violently  in  the  air  and  hold  it  for  an  instant,  and  again  re- 
peat it  until  the  pain  i-  subdued.  The  same  action  of  the 
lungs  occur-,  except  more  powerfully,  in  young  children 
who  take  to  crying  when  hurt.  It  will  be  noticed  they 
breathe  very  rapidly  while  furiously  crying,  which  -non  al- 
lays the  irritation,  and  sleep  conies  as  the  sequel.  Witne-- 
also  when  one  i-  suddenly  -tallied,  how  violently  the  breath 
is  taken,  which  give-  relief.  The  same  thing  occurs  in  the 
lower  animal.-  when  pain  is  beim:'  inflicted  at  the  hand  of 
man. 

This  was  advance  No.  :!.  and  -o  sure  was  I  of  this  new 
discovery,  that  I  at  once  made  an  application  while  removing 
decay  from  an  extremely  sensitive  tooth.  To  lie  -ucce--f;il. 
I  found  I  must  make  the  patient  take  the  -tait.  and  I  would 
follow  with  a  thru-t  from  the  excavator,  which  move  would 
be  accomplished  before  the  lung-  could  be  inflated.  This 
was  repeated  for  at  least  a  minute,  until  the  operation  was 
completed,  I  always  follow  jng  immediately  or  synchronously 
with  the  inhalation. 

This  led  to  sn  |  No  4.  which  re-ulted  in  its  application  to 
the  extracting  ol  teeth  and  ether  operations  in  minor  sur- 
gery. 

I'p  lo  this  time  I  had  believed  the  -rile  effect  of  the  rapid 
inhalation  was  due  to  mere  diversion  of  the  will,  and  tlii- 
wasliie  only  way  nature  could  -o  violently  exert  herself — 
that  of  controlling  the  involuntary  actj  n  of  the  lungs  to  hi  y 
u-i-  b\  the  -iififij  rah-f ,  tinder  the  voluntary  movement. 

The  con-tant  breathing  of  the  path  nt  for  thirty  seconds  to 
a  minute  left  him  in  a  condition  of  body  and  mind  re-em- 
hlinu'  the  effect-  of  ether  ano  chloroform  in  their  primary 
stages.  [  roulr]  hut  argue  thai  thf  prolonged  breaihing  fach 
time  had  done  ir :  and.  if  «i.  th'-n  there  mu-t  bf  oim  ,-p< 
cific  effect  over  and  above  the  mere  diversion  by  the  will. 
To  what  could  ii  be  due":  To  the  air  alone,  which  went  in 
excess  into  the  ltnm-  in  the  coin's.'  of  a  minute!  Why  did  1 
not  then  immediately  irrasp  the  idea  of  its  broader  applica- 
tion a-  now  claimed  for  it?    It  was  too  much,  gentlemen,  for 


that  hour.  Enough  had  been  done  in  this  fourth  step  of 
conception  to  rest  in  the  womb  of  time,  until  by  evolution  a 
higher  step  could  be  made  at  the  maturity  of  the  child.  Be- 
ing self-satisfied  with  my  own  baby,  1  watched  and  caressed 
it  until  it  could  take  care  of  itself,  and  my  mind  was  again 
free  for  another  conception. 

The  births  at  first  seemed  to  come  at.  very  short  intervals; 
but  see  how  long  it  was  between  the  fourth  and  the  fifth 
birth.  It  was  soon  after  that  my  mind  became  involved  in 
inventions — a  hereditary  outgrowth — and  the  electric  mallet 
and  then  the  dental  engine,  the  parent  of  your  surgical  en- 
gine, to  be  found  in  the  principal  hospitals  of  this  city,  took 
such  possession  of  ray  whole  soul,  that  my  air  analgesic  was 
left  slumbering.  It  was  not  until  August,  187.") —nineteen 
years  after — that  it  again  came  up  in  full  force,  without  any 
previous  warning. 

This  time  it  was  no  law  of  association  that  revived  it;  but 
it  seemed  the  whispering  of  sonic  one  in  the  air— some  ethe- 
real spirit,  if  you  pleas( — which  instituted  it.  and  advanced 
the  following  problem:  "Nitrous  oxide  gas  i-  composed  of 
the  same  elements  as  ordinary  air,  with  a  larger  equi- 
valent of  oxygen,  except  it  is  a  chemical  compound,  not  a 
mechanical  mixture,  and  its  anaesthetic  effects  are  -aid  to  be 
due  to  the  excess  of  oxygen.  If  this  lie  ;i  fact,  then  why  can 
you  not  produce  a  similar  effect  by  rapid  breathing  for  a 
minute,  more  or  less,  by  which  a  larger  quantity  of  oxygen 
is  presented  in  the  lungs  for  absorption  by  the  blood?" 

This  query  was  soon  answered  by  asking  my.-elf  another. 
"  If  the  rapid  inhalation  of  air  into  the  lungs  does  not  in- 
crease the  heart's  action  and  cause  it  to  drive  the  blood  in 
exact  ratio  to  the  inhalations,  then  /  can  produce  partial 
anaesthesia  from  this  excess  of  oxygen  brought  about  by  the 
voluntary  movements  over  the  ordinary  involuntary  action 
of  the  lungs."  The  next  question  was:  "  Will  my  heart  be 
affected  by  this  excess  of  air  in  the  lungs  to  such  an  extent 
that  there  will  be  a  full  reciprocity  between  them?"  Without 
making  any  trial  of  it,  I  argued  thai,  while  there  is  no  other 
muscular  movement  than  that  of  the  chest  as  under  the  con 
trol  of  the  will,  and  as  nature  ha-  given  to  the  will  the  per- 
fect control  over  the  lungs  to  supply  more  or  less  air  a-  is 
demanded  by  the  pneumogastric  nerve  for  the  immediate 
wants  of  the  economy,  when  the  involuntary  fiction  is  not 
sufficient;  and  the  heart  not  being  under  the  control  of  the 
will,  and  its  action  never  accelerated  or  diminished  except 
by  a  specific  poison,  or  from  the  general  activity  of  the  per- 
son in  violent  running  or  working,  the  blood  i-  forced  into 
the  heart  faster  and  must  gel  rid  of  it,  when  a  larger  supply 
of  oxygen  is  demanded  and  rapid  breathing  must  occur,  or 
asphyxia  result.  I  was  not  long  in  deciding  that  the  heart 
mould  not  be-  accelerated  but  a  trifle— say  a  tenth — and.  under 
the  circumstances,  I  said:   "The  air  is  an  anaesthetic." 

From  this  rapid  course  of  argument,  I  was  so  profoundly 
convinced  of  its  truth,  that  without  having  first  tried  it  upon 
my  own  person.  I  would  have  sat  where  1  was.  upon  the 
curbstone,  and  had  a  tooth  removed,  with  the  perfect  expect- 
ation of  absence  of  pain  and  of  -till  being  conscious  of 
touch.  While  yet  walking,  I  commenced  to  breathe  as 
rapidly  as  possible,  and.  a>  anticipated,  found  my  steps 
growing  shorter  and  shorter,  until  [  cone  to  a  stand, 
showing  to  my  mind  clearly  that  my  argument  in  advance 
was  right,  so  far  as  locomotion  was  concerned;  and,  upon 
referring  to  my  pulse,  I  found  but  little  acceleration. 


T < >  wli.it  ni her  conclusion  could  1  arrive  from  this  argu- 
ment, with  tlir  foundation  laid  nineteen  years  before,  when  1 
established  on  my  own  person  by  experiment  the  fad  of 
analgesia  a>  induced  from  chloroform,  \\  ilh  tlie  many  experi- 
inenK  in  rapid  respiration  on  tooth  bone? 

From  ihis  moment  until  it-  first  application  to  the  extrac- 
ii  >n  of  a  loitli  you  can  well  imagine  m\  suspense.  Thai  1 
might  not  fail  in  the  very  firsl  attempt.  1  compelled  myself 
and  others  in  my  household  to  breathe  rapidly  to  investigate 
l lie  phenomenon.  This  uavc  me  some  idea  as  to  the  propel 
method  of  proceeding  in  its  administration. 

The  lirst  ease  soon  appeared,  and  was  a  perfect  success. 
Lroing  far  beyond  my  anlieipations,  for  the  cfTect  was  such 
as  in  produce  a  partial  paralysis  of  the  ham  is  a  ml  arms  to  the 
elbow.  Again  and  again  I  tried  it  in  every  ease  of  extrac- 
tion and  many  other  experiments,  doubting  my  own  senses 
for  a  long  time  at  a  result  so  anomalous  ;ind  paradoxical.  I 
was  reminded  jus*  here  f  a  phenomenon  which  uavc  me  addi- 
tional pr  ii  if— Mi.- 1 1  of  blowing  a  dull  tire  to  revive  it.  For  a 
minute  or  so  one  blows  and  blows  in  rapid  succession,  until. 
rising  from  the  effort,  a  sense  of  giddiness  for  a  few  mo 
incuts  so  overcomes  that  the  upriirhi  position  is  with  ditli 
c  id  t  y  maintained.  In  this  condition  you  are  lit  ted  for  ha  vim; 
a  tooth  extracted  or  an  abscess  lanced. 

Believing  that  1  had  something  new  to  offer  which  might 
In  of  use  to  suffering  humanity.  I  read  the  first  article  upon 
ii  Nov.  17.  IS?."),  before  the  Franklin  Institute.  Shortly  after 
1  was  invited  before  I  he  Northern  Medical  Society  of  this 
city  to  address  them  thereon.  A  mini  her  of  medical  gentle- 
men have  been  using  ii  in  their  practice,  while  the  bulk  of 
them  have  spurned  ii  as  "  negative  "  and  preposterous,  with- 
out an  effort  at  Irving  i\  which  I  can  ii<»r  very  well  under- 
stand. 

I  nless  one  j^  aware  of  the  fact  that  in  the  u-i-  of  any  agent 
which  ha-  1 1 1 ■  -  powei  lo  suspend  the  volition,  it  can  be 
taken  in  I  hat  point  where  he  is  still  conscious  of  fm/r/i 
•  imi  Inuring,  and  at  the  same  time  not  cognizant  of  pain  in- 
tlieieii.  i  lie  action  of  rapid  breathing  can  not  be  under- 
stood. And  I  I'euTet  to  say  thai  of  threi  fourths  of  the 
medical  im  n  I  have  lalked  with  on  the  subji  et  they  had  not 
licet)  aware  ut  si, eh  a  possibility  from  ether  ami  chloroform. 
I  Tit il  'hi-  analgesic  siate  could  lie  esiablished  in  their  minds 
i !  was  impossible  to  convince  the  in  that  the  excess  of  oxygen. 
lined  by  rapid  breathing,  could  In  made  to  produce  a 
simil  ,r  etl'ect  /  should  liave  lieen  ;i~  reluctant  as  any  one  to 
■"Ii  veil,  had  1  not  personally  experienced  the  etl'ect  while 
performing  an  operation  which  would  otherwise  have  been 
\ a  r \  painful.  Such  a  result  could  not  well  be  reached  by 
an.\  course  oi  n  asoniim  alone. 

Has  ji  pr.'iveii  in  in\   practice  what   ha-   been  claimed  \"f  it 

asubsiituie  for  the  powerful  ana'>ihctics  in  minor  ope  ra- 
I  '■  n-  ill  -  i '  _a  ! ".  V  NIosi  einphat  ieally.  \  >  -  '  So  eompleti 
has  ii  fulfilled  it-  humble  mission  in  my  office,  that  I  can 
-■lib  assert  then  ha-  no!  been  nmii  than  rivt  per  cent. 
1  ha vc  given  it  under  all  cireiimstanees  eif  eli- 
eased  organs,  and  have  -een  no  either  thar  tin  happi*-> 
results  ii,  its  after  effects.  ['  may  wall  b  .;-keel  jn-T  hen 
Why  has  ii  not  been  ni"r<  LTeiierally  and  widely  u-e.i  by  tin 
dental  pr  fe--ion  a-  well  as  the  nvdical.  if  it  i-  ieally  what 
is  claimeo  for  it?  The  meisi  satisfactory  and  charitable 
it  -'.vi  r  to  In  driven  i-.  the  failure  upon  their  part  to  compre 
.  the  fnrt  a-  existing   in    chloroform  and   ether  that  there 


is  such  a  state  as  analgesia;  or,  in  other  words,  that  the 
animal  economy  is  so  organized,  while  the  sense  of  touch  is 
not  destroyed,  hut  rather  increased,  the  mind  of  the  subject 
fails  to  perceive  a  sense  of  pain  when  anaesthetics  are  given, 
and  the  effects  are  manifested  in  the  primary  stage.  As  I 
before  intimated,  such  is  the  knowledge  possessed  by  most 
of  those  who  administer  ether  and  chloroform.  This  was 
enough  to  cause  nearly  every  one  to  look  upon  it  as  a  bubble  or 
air  castle.  Many  gentlemen  told  me  they  tried  it  upon  them 
selves,  and,  while  it  affected  them  very  seriously  by  giddi- 
ness, they  stil!  retained  consciousness ;  and.  such  being  the 
case,  no  effect  could  be  produced  for  obtunding  pain.  Others 
l old  me  they  were  afraid  to  continue  the  breathing,  alarmed 
at  the  vertigo  induced.  And  the  practitioner  who  has 
adopted  it  more  effectively  than  any  other  laughed  at  me 
when  I  first,  told  him  of  the  discovery ;  but  his  intimate  asso- 
ciation Avith  me  changed  his  views  after  much  explanation 
and  argument  between  us. 

It  was  hardly  to  be  expected  that  without  this  knowledge 
of  analgesia,  and  without  any  explanation  from  me  as  to  the 
Hindus  operandi  of  rapid  breathing,  other  than  a  few  sug- 
gestions or  directions  as  to  how  the  effect  was  induced,  even 
the  most  liberal  of  medical  men  should  be  able  to  make  it 
effective,  or  have  the  least  disposition  to  give  il  a  preliminary 
trial  upon  themselves,  and,  of  course,  would  not  attempt  it 
upon  a  patient.  Notwithstanding,  il  found  a  few  adherents, 
but  only  among  my  personal  medical  friends,  with  whom  1 
had  an  opportunity  to  explain  what  1  believed  its  physiologi- 
cal action,  and  the  cases  of  success  in  my  own  practice.  To 
this  1  have  submitted  as  among  t lie  inevitable  in  the  calendar 
of  discoveries  of  all  grades. 

My  own  profession  have  attempted  to  ridicule  it  out  of  its 
birthright  and  possible  existence,  which  style  of  argument  is 
not   resorted  lo  by  true  logicians. 

To  all  this  1  can  truly  say  1  have  not  for  one  moment  fal- 
tered. 1  could  afford  lo  wait.  The  liberality  of  this  society 
alone  fully  compensates  for  the  seeming  indisposition  of  the 
past,  believing  thai  il  is  proper  thai  every  advance  should 
be  confronted,  and,  if  in  time  found  worthy,  give  it  God 
speed. 

From  its  first  conception  I  have  diligently  labored  to  solve 
its  modus  operandi,  and  the  doubt  in  my  own  mind  as  to 
whether  I  could  be  mistaken  in  my  observations.  1  asked 
the  opinion  of  our  best  chemical  teachers  if  air  could  have 
such  effect.  One  attributed  it  to  oxygen  stimulation,  and 
the  other  to  nitrogen.  Another  gentleman  told  me  the  medi- 
cal profession  had  come  to  I  he  conclusion  that  it  was  possible 
for  me  to  thus  extract  teeth,  but  il  was  due  solely  to  my 
strong  personal  mar/neHsm,  i  which  power  1  was  noi  before 
aware  1  possessed). 

Now,  from  what  I  have  related  of  the  successive  and 
natural  steps  which  finally  culminated  in  this  process  or  plan 
of  analgesia  induced  by  an  excess  of  ordinary  air  taken 
forcibly  into  the  lungs  above  what  is  necessary  for  life,  and 
from  what  I  shall  state  a-  to  the  apparently  anomalous  or 
paradoxical  effects,  with  its  physiological  action,  and  the 
simple  tests  made  upon  each  of  my  patients,  I  shall  trust  to 
so  convince  you  of  its  plausibility  and  possibility  that  il  will  be 
made  use  of  in  hundreds  of  minor  operations  where  ether 
and  chloroform  are  now   used. 

Aside  from  my  assertion  and  thai  of  its  friends,  that  (he 
effects  can  be  produced   by  air  alone,  you    must    have  some 


light  shed  upon  the  causes  of  its  physiological  action,  which 
will  appeal  to  your  mediral  reason. 

To  assign  an  action  to  any  drug  is  difficult,  and  in  the 
cases  of  ether  and  the  other  anaesthetics  a  quarter  of  a  century 
still  finds  many  conflicting  opinions.  This  being  true,  you 
will  deal  leniently  with  ine  for  the  opinion  I  hold  as  to  their 
analgesic  action.  Of  course  it  will  be  objected  to.  for  the 
unseen  is,  to  a  great  extent,  unknowable.  Enough  for  my 
argument,  however;  it  seems  to  suit  the  case  very  well  with- 
out looking  for  another;  and  while  it  was  based  on  the 
phenomenon  resulting  from  many  trials,  and  not  the  trials 
upon  it  as  a  previous  theory,  1  shall  be  content  with  it  until 
a  better  one  can  be  found. 

What  i-  it  1  claim  a-  a  new  discovery,  and  the  facts  and 
its  philosophy? 

1  have  asserted  thai  I  can  produce,  from  rapidly  breathing 
common  air  at  the  rate  of  a  hundred  respirations  a  minute, 
a  similar  effect  to  that  from  ether,  chloroform,  and  nitrous 
oxide  gas,  in  their  primary  stages;  and  I  can  in  this  way 
render  patients  sufficiently  insensible  to  acute  pain  from  any 
operation  where;  the  time  consumed  is  not  over  twenty  to 
1  hi rty  seconds.  While  the  special  senses  are  in  partial  ac- 
tion, the  sense  of  pain  is  obtunded,  and  in  many  cases  com- 
pletely annulled,  consciousness  and  general  sensibility  being 
preserved. 

To  accomplish  tin-,  each  patient  must  be  instructed  how 
to  act  and  what  to  expect.  As  simple  a-  it  may  seem,  there 
i-  a  proper  and  consistent  plan  to  enable  you  to  reach  full 
success.  Before  the  patient  commences  to  inhale  he  is  in 
formed  of  the  fact  that,  while  he  will  be  unconscious  of  pain, 
he  will  know  full  or  partially  well  every  touch  upon  the 
person;  that  the  inhalation  must  be  vigorously  kept  up 
during  the  whole  operation  without  for  an  instant  stopping; 
that  the  more  energetically  and  steadily  he  breathes,  the 
more  perfect  the  effect,  and  that  if  he  cease  breathing  dur- 
ing the  operation,  pain  will  he  felt.  Fully  impress  them 
with  this  idea,  for  the  very  good  reason  that  they  may  stop 
when  in  the  midst  of  an  operation,  and  the  fullest  effects  be 
.ost.  It  is  obligatory  to  do  so  on  account  of  its  evanescenl 
effects,  which  demand  that  the  patient  be  pushed  by  the 
operator'-  own  energetic  appeals  to  "go  on."  It  is  very  dif 
ficuit  for  any  person  to  respire  more  than  one  hundred  times  to 
the  minute,  as  lie  will  become  by  that  time  so  exhausted 
as  not  to  be  able  to  breathe  al  all.  as  is  evidenced  by  all  who 
have  thus  followed  my  directions.  For  the  next  minute  fol 
lowing  the  completion  of  the  operation  the  stibject  will  not 
breathe  more  than  once  or  twice.  Very  few  have  force 
enough  left  to  raise  hand  or  foot.  The  voluntary  muscles 
have  nearly  all  been  subjugated  and  overcome  by  the  undue 
ell'ort  at  forced  inhalation  of  one  hundred  over  seventeen, 
i  he  normal  standard.  It  will  be  more  fully  understood 
further  on  in  my  argument  why  1  force  patients,  and  am 
constantly  -peaking  to  them  to  go  on. 

1  further  claim  that  for  the  past  four  years,  so  satisfactory 
ha- been  the  result  of  this  system  in  'he  extracting  of  teeth 
and  deadening  extremely  sensitive  dentine,  there  was  no 
longer  any  necessity  for  chloroform,  ether,  or  nitrous  oxide 
in  the  denial  office.  That  such  teeth  as  cannot  be  extracted 
by  its  aid  can  well  be  preserved  and  made  useful,  except  in 
a  very  few  erases,  who  will  not  be  forced  to  breathe. 

The  anse-theties,  when  used  in  major  operations,  where 
time  is  needed  for  the  operation,  can  be  made  more  effective 


I iy  a  lesser  quantity  when  given  in  conjunction  with  "  rapid 
breathing."  Drs.  Garrettson  and  Hewson,  who  have  thus 
tried  it,  tell  me  it  takes  one-half  to  three-fourths  less,  and  the 
after  effects  are  far  less  nauseating  and  unpleasant. 

As  an  agent  in  labor,  where  an  aiucsthetic  is  indicated,  it  is 
claimed  by  one  who  has  employed  it  (Dr.  Hewson)  in  nearly 
every  case  for  three  years,  lie  has  used  "  rapid  breathing  " 
solely,  and  to  the  exclusion  of  chloroform  and  ether.  For 
this  1  have  his  assertion,  and  have  no  doubt  of  it  whatever, 
for  if  any  agent  could  break  down  the  action  of  the  volun- 
tary muscles  of  the  parts  involved,  which  prevent  the  invol- 
untary muscles  of  the  uterus  from  having  their  tidiest  effect, 
il  is  (his.  The  very  act  of  rapid  breathing  so  affects  the 
muscles  of  the  abdomen  as  to  force  the  contents  of  the  uterus 
downward  or  outward,  while  the  specific  effect  of  the  air  at 
I  lie  end  of  a  minute's  breathing  leaves  the  subject  in  a  semi- 
prostrate  condition,  giving  the  uterus  full  chance  to  act  in 
the  interim,  because  free  of  the  will  to  make  any  attempt  at 
withholding  the  involuntary  muscles  of  the  uterus  from 
doing  their  natural  work.  It  is  self  evident;  and  inthisagenl 
we  claim  here  a  boon  of  inestimable  value.  And  not  least 
in  such  cases  is.  there  i.~  no  danger  of  hemorrhage,  since  the 
cause  of  the  effect  is  soon  removed. 

In  attestation  of  many  cases  where  it  has  been  tried,  1  have 
asked  the  mother,  and.  in  some  cases,  the  attendants. 
whether  anything  else  had  been  given,  and  whether  the  time 
was  very  materially  lessened;  there  has  been  bid  one 
response,  and  that  in  its  favor. 

Gentlemen,  if  we  are  not  mistaken  in  this,  you  will  agree 
with  me  in  saying  that  it  is  no  mean  thing,  and  should  be 
investigated  by  intelligent  men  and  reported  upon.  From 
my  own  knowledge  of  its  effects  in  my  practice,  I  am  bound 
'o  believe  this  gentleman's  record 

1  further  claim  for  it  a  special  application  in  dislocations. 
It  has  certainly  peculiar  merits  here,  as  the  will  is  so  nearly 
subjugated  by  it  as  to  render  the  patient  quite  powerless  to 
resist  your  effort  at  replacing,  and  at  the  same  time  the  pain 
is  subdued. 

It  is  not  necessary  1  should  further  continue  special  appli- 
cations; when  its  modus  opiraraU  is  understood,  its  adapta- 
tion to  many  contingencies  will  of  a  sequence  follow. 

It  is  well  just  here,  before  passing  to  the  next  point  of  con- 
sideration, to  answer  a  query  which  may  arise  at  Ibis  junc- 
ture: 

What  are  the  successive  stages  of  effects  upon  the  economy 
from  its  commencement  until  the  full  effect  is  observed, 
and  what  proof  have  1  that  it  was  due  to  the  amount  of  air 
inhaled? 

The  heart's  action  is  not  increased  more  than  from  seventy 
(the  average)  to  eighty  and  sometimes  ninety,  but.  is  much 
enfeebled,  or  throwing  a  lesser  quantity  of  blood.  The  face 
becomes  suffused,  as  in  blowing  a  tire  or  in  stooping,  which 
continues  until  the  breathing  is  suspended,  when' the  face 
becomes  paler.  (Have  not  noticed  any  purple  as  from  as- 
phyxia by  a  deprivation  of  oxygen.)  The  vision  becomes 
darkened,  and  a  giddiness  soon  appears.  The  voluntary 
muscles  furthest  from  the  heart  seem  first  to  be  affected,  and 
the  feet  and  hands,  particularly  the  latter,  have  a  numbness 
at  their  extremities,  which  increases,  until  in  many  casesjhere 
i-  partial  paralysis  as  far  as  the  elbow,  while  the  limbs  be 
come  fixed.  The  hands  are  so  ihoroughly  affected  that, 
when  open,  the  patient    is   powerless   to  close  them  and   Her 


versa.  There  is  a  vacant  gaze  from  the  eyes  and  looking  into 
space  without  blinking  of  the  eyelids  for  a  minute  or 
mure.  The  head  seems  incapable  of  being  held  erect,  and 
there  is  no  movement  of  the  arms  or  legs  as  is  usual  when  in 
great  pain.  There  is  no  disposition  on  the  part  of  the  pa 
tient  to  take  hold  of  the  operator's  hand  or  interfere  with  the 
operation. 

.Many  go  on  breathing  mechanically  after  the  tooth  is  re- 
moved, as  if  nothing  had  occurred.  Some  are  aware  that 
the  tooth  has  been  extracted,  and  say  they  felt  it;  other- 
could  not  tell  what  had  been  accomplished.  The  majority 
of  cases  have  an  idea  of  what  i-  being  done,  but  are  power 
less  to  resist. 

With  the  very  intelligent,  or  those  who  stop  to  reason.  1 
have  to  leach  them  1  he  peculiarities  of  being  sensible  of  touch 
and  not  of  pain. 

One  very  interesting  case  I  will  state.  In  extracting  seven 
teeth  for  a  lady  who  was  very  uittriUing  to  believe  my  state- 
ment as  to  touch  and  no  pain,  1  h'rsl  removed  three 
teeth  after  having  inhaled  for  one  minute,  and  when 
fully  herself,  she  stated  that  she  could  not  understand  why 
there  wa-  no  pain  while -lie  was  conscious  of  each  one  ex 
traeted;  it  was  preposterous  to  believe  such  an  effect  could 
he  possible.  a>  her  reason  told  her  that  there  is  connected 
with  tooth  extracting  pain  in  the  part,  and  of  severe  charac- 
ter, admitting,  though,  she  felt  no  pain.  She  allowed  one' 
to  be  remove  i  without  anything,  and  -lie  could  easily  dis- 
tinguish the  change,  and  exclaimed.  "  It  is  all  the  difference 
imaginable:"  When  the  other  three  were  extracted,  there 
was  perfect  succc-s  again  as  with  the   first  three. 

One  of  the  most  marked  proofs  of  the  effects  of  rapid 
breathing  was  that  of  a  boy  of  eleven  years  of  age  for  whom 
I  had  to  extract  the  upper  and  lowei  first  permanent  molars 
on  each  side.  lie  breathed  for  nearly  a  minute,  when  1  re- 
moved in  about  twenty  seconds  all  four  of  the  teeth. 
without  a  moment's  intermission  or  the  stopping  the  vigor- 
ous breathing:  and  not  a  murmur,  sigh,  or  tear  afterward. 

He  declared  there  was  no  pain,  and  we  needul  no  such 
assertion,  for  there  wa-  not  the  first  manifestation  from  him 
that    he  was  undergoing  such  a  severe  operation. 

Another  case,  the  same  day,  when  I  had  to  extract  the  -u 
perior  wisdom  teeth  on  both  sides  for  an  intelligent  young 
lady  of  eighteen  years,  where  I  had  to  use  two  pairs  of  for- 
ceps on  each  tooth  (equivalent  to  extraction  of  four  teeth i. 
-he  was  so  profoundly  affected  afterward  that  she  could 
not  tell  me  what  had  been  done  other  than  that  1  had  touched 
her  four  times.  Sin- was  overcome  from  its  effect-  for  at 
lea~t  a  minute  afterward.      She  was  delighted. 

With  such  severe  tests  1  fear  very  little  the  result  in  any 
case  where  1  can  have  them  do  as  1  bid. 

There  can  be  no  mistake  that  there  is  a  specific  actio n  from 
something.  It  cannot  he  personal  magnetism  or  mesmeric 
influence  exerted  by  me.  for  such  case-  are  rare,  averaging 
about  10  percent,  only  of  all  classes.  Besides,  in  mesmeric 
influence  the  t  ime  ha~  much  to  do  with  it:  whereas,  in  my 
case-,  it  cannot  last  over  a  half  minute  or  minute  at  most. 
It  cannot  be  fear,  a-  such  eases  are  generally  more  apt  to 
gel  hurl  the  wor-c.  It  b  not  diversion  of  mind  alone,  as  we 
have  an  effect  above  it. 

There  is  no  better  way  of  testing  whether  pain  has  been 
fell  than  by  taking  the  lacerated  or  contused  gums  of  the  pa- 
tient bet  ween  the  index    finger   and    thumb   and    making   a 


gentle  pressure  to  collapse  the  alveolar  borders;  invariably, 
they  will  cry  out  lustily,  that  is  pain  !  This  gives  undoubted 
proof  of  a  specific  agent.  There  is  no  attempt  upon  my 
own  part  to  exert  any  influence  over  my  patients  in  any  way 
other  than  that  they  shall  believe  what  I  say  in  regard  to  giring 
ihem  in/  in/in  and  in  the  following  of  my  orders.  Any  one 
who  knows  how  persons  become  mesmetized  can  attest  thai  it 
is  not  the  operator  trho  forces  them  under  it  against  their  trill, 
but  it  is  a  peculiar  state  into  which  any  who  have  within 
themselves  this  temperament  can  place  themselves  where  any 
one  who  knows  how  can  have  control.  It  is  not  the  will  of 
the  operator.  I  therefore  dismiss  this  as  unworthy  of  con 
sideration  in  connection  with  rapid  breathing. 

Then  you  may  now  ask,  To  what  do  I  attribute  thi-  very 
singular  phenomenon  ? 

Any  one  who  followed,  in  the  earlier  part  of  this  paper, 
the  course  of  the  argument  in  my  soliloquy,  after  twenty 
years  had  elapsed  from  my  observation  upon  myself  of  the 
analgesic  effects  of  chloroform,  can  almost  give  something  of 
an  answer. 

That  you  may  the  more  easily  grasp  what  I  shall  say,  1 
will  ask  you,  If  it  be  possible  for  any  human  being  to  make 
one  hundred  inhalations  in  a  minute  and  the  heart's  action 
is  not  increased  more  than  ten  or  twenty  pulsations  over  the 
normal,  what  should  be  the  effect  upon  the  brain  and  nerve 
centers? 

If  the  function  of  oxygen  in  common  air  is  to  set  free  in 
the  blood,  either  in  the  capillaries  alone,  or  throughout  the 
whole  of  the  arterial  circulation,  carbonic  acid  gas;  and  that 
it  cannot  escape  from  the  system  unless  it  do  so  in  the 
lungs  as  it  passes  in  the  general  current — except  a  trace  that 
is  removed  by  the  skin  and  kidneys — and  that  the  quantity 
of  carbonic  acid  gas  set  free  is  in  exact  relation  to  the 
amount  of  oxygen  taken  into  the  blood,  what  effect  muxt  be 
manifested  where  one  hundred  respirations  in  one  min- 
ute are  made — five  or  six  times  the  normal  number — while 
the  heart  is  only  propelling  the  blood  a  very  little  faster 
through  the  lungs,  and  more  feebly — say  !)()  pulsations  at  most, 
when  to  be  in  proportion  it  should  be  400  to  100  respirations 
to  sustain  life  any  length  of  time? 

You  cannot  deny  the  fact  that  a  definite  amount  of  oxy- 
gen can  be  absorbed  and  is  absorbed  as  fast  as  it  is  carried 
into  the  lungs,  even  if  there  be  one  hundred  respirations 
to  the  minute,  while  the  pulsations  of  the  heart  are  only 
ninety!  Nature  has  made  it  possible  to  breathe  so  rapidly  to 
meet  any  emergency;  and  we  can  well  see  its  beautiful  ap- 
plication in  the  normal  action  of  both  the  heart  and  lungs 
while  one  is  violently  running. 

What  would  result,  and  that  very  speedily,  were  the  act 
of  respiration  to  remain  at  the  standard — say  IS  or  '20 — when 
the  heart  is  in  violent  action  from  this  running?  Asphyxia 
would  surely  end  the  matter!  And  why?  The  excessive 
exercise  of  the  "whole  body  is  setting  free  from  the  tissues 
such  an  amount  of  excretive  matter,  and  carbon  more  largely 
than  all  I  he  others,  that,  without  a  relative  action  of  the 
lungs  to  admit  the  air  that  oxygen  may  be  absorbed,  car- 
bonic acid  gas  cannot  be  liberated  through  the  lungs  as  fast 
as  the  waste  carbon  of  the  overworked  tissues  is  being  made 
by  disassimiiation  from  this  excess  of  respiration. 

You  are  already  aware  how  small  a  quantity  of  carbonic 
acid  in  excess  in  the  air  will  seriously  affect  life.  Even  2  to 
'4  per  cent,   in   a  short_  time  will    prove  fatal.     In    ordinary 


10 


respiration  of  2(1  to  the  minute  the  average  of  carbonic  acid 
<  xhaled  is  4 '35. 

From  experiments  long  ago  made  by  Vierordt — see  Car- 
penter, p.  524 — you  will  see  the  relative  per  cent,  of  car 
bonic  acid  exhaled  from  a  given  number  of  respirations. 
When  he  was  breathing  six  times  per  minute,  5  5  per  cent, 
of  the  exhaled  air  was  carbonic  acid:  twelve  limes.  4'2: 
twenty-four  times,  8  3;  forty-eight  times.  3;  ninety-six  times, 
2  0. 

Remember  this  is  based  upon  the  whole  number  of  respi- 
rations in  the  minute  and  not  each  exhalation — which  latter 
could  not  be  measured  by  the  most  minute  method. 

Let  us  deduct  the  minimum  amount,  20  per  cent,  of  car 
bonic  acid  when  breathing  ninety-six  times  pe.  minute,  from 
the  average,  at  twenty  per  minute,  or  the  normal  standard, 
which  is  recorded  in  Carpenter,  p.  524.  as  4-85  per  minute,  and 
we  have  retained  in  the  circulation  nearly  2  per  cent,  of  car 
bonic  acid;  that,  at  the  average,  would  have  passed  off 
through  the  lungs  without  any  ob-ti  uction,  and  life  equal- 
ized; but,  not  having  been  thrown  off  as  fast  as  it  should 
have  been,  it  must,  of  necessity,  be  left  to  prey  upon  the 
brain  and  nerve  centers;  and  as  2  to  3  per  cent.,  we  are  told. 
will  so  poison  the  blood,  life  is  imperiled  and  that  speedily. 

It  is  not  necessary  we  should  argue  the  point  as  to  whether 
oxygen  displaces  carbonic  acid  in  the  tissues  proper  or  the 
capillaries.  The  theory  of  Lavoisier  on  this  point  has  been 
accepted. 

We  know  furthermore,  as  more  positive,  that  tissues  placed 
in  an  atmosphere  of  oxygen  will  set  free  carbonic  acid,  and 
that  carbonic  acid  has  a  paralyzing  effect  upon  the  human 
hand  held  in  it  for  a  short  time.  The  direct  and  speedy 
effects  of  this  acid  upon  the  delicate  nervous  element  of  the 
brain  is  so  well  known  that  it  must  be  accepted  as  law.  One 
of  the  most  marked  effects  is  the  suspension  of  locomotion 
of  the  legs  and  arms,  and  the  direct  loss  of  will  power  which, 
must  supervene  before  voluntary  muscular  inactivity,  which 
amounts  to  partial  paralysis  in  the  hands  or  feet,  or  periphe- 
ral extremities  of  the  same. 

Now  that  we  have  sufficient  evidence  from  the  authorities 
that  carbonic  acid  can  be  retained  in  the  blood  by  excessive 
breathing,  and  enough  to  seriously  affect  the  brain,  and 
what  its  elfeets  are  when  taken  directly  into  the  lungs  in  ex- 
cess, we  can  enter  upon  what  1  have  held  as  the  most  rea- 
sonable theory  of  the  phenomenon  produced  by  rapid  breath 
ing  for  analgesic  purposes;  which  ilitonj  was  not  fust  con- 
ceived and  the  process  made  to  yield  to  it,  but  the  phenom- 
enon waslong  observed,  and  from  the  repetition  of  the  effects 
and  their  close  relationship  to  that  of  carbonic  acid  on  the 
economy,  with  the  many  experiments  performed  upon  my- 
self, 1  am  convinced  that  what  1  shall  now  state  will  be 
found  to  substantiate  my  discovery.  Should  it  not  be  found 
to  coincide  with  what  some  may  say  is  physiological  truth, 
it  will  not  invalidate  (he  discovery  itself;  for  of  that  I  am 
far  more  positive  than  Harvey  was  of  the  di  eovery  of  the 
circulation  of  the  blood;  or  of  Galileo  of  the  spherical  shape 
of  the  earth.  And  1  ask  that  it  shall  not  be  judged  by  my 
theory,  but  from  the  practice. 

It  should  have  as  much  chance  for  investigation  as  the 
theory  of  Julius  Robert  Mayer,  upon  which  he  founded,  or 
which  gave  rise  to  the  establishment  of  one  of  tin1  most  im- 
portant scientific  truths — "  the-  conservation  of  energy,"  and 
finallv  the  "correlation  of  forces."   which  theory  I  am  not 


11 

quite  sure  was  correct,  although  it  was  accepted,  and  as  yet 
1  have  not  seen  it  questioned. 

In  all  due  respect  to  him  I  quote.it  from  the  sketch  of  that 
remarkable  man,  as  given  in  the  Popular  Science  Monthly,  as 
specially  hearing  on  my  discovery: 

"Mayer  observed  while  living  in  Java,  that  the  cenovs 
blood  of  some  of  his  patients  had  a  singularly  bright  red  color. 
The  observation  riveted  his  attention;  he  reasoned  upon  it, 
and  came  to  the  conclusion  that  the  brightness  of  the  color 
\\as  due  to  the  fact  that  a  less  amount  of  oxidation  was  suf- 
ficient to  keep  up  the  temperature  of  the  body  in  a  hot  cli 
mate  than  a  cold  one.  The  darkness  of  the  venous  blood  he 
regarded  as  the  visible  sign  of  the  energy  of  the  oxidation." 

My  observation  leads  me  to  the  contrary,  that  the  higher 
the  temperature  the  more  rapid  the  breathing  to  get  clear  of 
theexcess  of  carbon,  and  hence  more  oxygenation  of  the 
blood  which  will  arterialize  the  venous  blood,  unless  there  is 
a  large  amount  of  carbonized  matter  from  the  tissues  to  be 
taken  up. 

Nor  must  it  be  denied  because  of  the  reasoning  as  pre 
sented  to  my  mind  by  some  outside  influence  in  my  so 
liloquy  when  1  first  exclaimed,  "Nature's  anaesthetic," 
where  the  argument  as  to  the  effects  of  nitrous  oxide  gas 
being  due  to  an  excess  of  oxygen  was  urged,  and  that  com- 
mon air  breathed  in  excess  would  do  the  same  thing. 

1  am  not  sure  that  it  was  correct,  for  the  effect  of  nitrous 
oxide  is,  perhaps,  due  to  a  deprivation  of  mechanically  mixed 
air. 

Knowing  what  1  do  of  theory  and  practice,  1  can  say  with 
assurance  that  there  is  not  a  medical  practitioner  who  would 
long  ponder  in  any  urgent  case  as  to  the  thousand  and  one 
theories  of  the  action  of  remedies,  but  would  resort  to  the 
practical  experience  of  others  and  his  own,  finally.  (What 
surgeon  ever  stops  to  ask  how  narcotics  effect  their  influ- 
ence?) Alter  nearly  thirty  years  of  association  will)  ether 
and  chloroform,  who  can  positively  answer  as  to  their  modus 
operandi:  It  is  thus  with  nearly  the  whole  domain  of  medi- 
cine. It  is  not  yet,  by  far,  among  the  sciences,  with  immu- 
table laws,  such  as  we  have  in  chemistry.  Experimentation 
is  giving  us  more  specific  knowledge,  and  "practice  alone 
has  tended  lo  make  perfect."  Then,  gentlemen  will  not  set 
at  naughl  my  assertion  and  practical  results.  When  1  have 
stated  my  case  in  full  it  is  for  you  to  disprove  both  the  theory 
and  practice  annunciated.  So  far  as  I  am  concerned  I  am 
responsible  for  both. 

You  will  please  bear  with  me  for  a  few  minutes  in  my 
attempt  at  theory. 

The  annulling  of  pain,  and,  in  some  cases,  its  complete  anni- 
hilation, can  be  accomplished  in  many  ways.  Narcotics,  an- 
aesthetics— local  and  internal — direct  action  of  cold,  and  mes- 
meric or  psychological  influence,  have  all  their  advocates, 
and  each  ir ill  surely  do  its  work.  There  is  one  thing  about 
which,  1  think,  we  can  all  agree,  as  to  these  agencies:  unless 
the  will  is  partially  and  in  some  cases  completely  subjugated 
there  can  be  no  primary  or  secondary  effect.  The  voluntary 
muscles  must  become  wholly  or  partially  paralyzed  for  the 
time.  Telegraphic  communication  must  he  cut  off  from  the 
brain,  that  there  be  no  reflex  action.  It  is  not  necessary  there 
should  be  separate  nerves  to  convey  pleasure  and  pain  any- 
more than  there  should  be  two  telegraphic  wires  to  convey 
two  messages. 

If,  then,  we  are   certain   of   this,    it    matters   little    as    to 


12 


whether  it  was  done  by  corpuscular  poisoning  and  anaemia 
as  from  chloroform  or  hyperemia  from  ether. 

1  think  we  are  now  prepared  to  show  clearly  the  causes 
which  effecl  I  he  phenomena  in  "  rapid  breathing." 

The  first  thing  enlisted  is  the  dicerxion  off/it  will  force  in 
the  act  of  forced  respiration  at  a  moment  when  the  heart 
and  lungs  have  been  in  normal  reciprocal  action  ("20  respi- 
rations to  80  pulsations),  which  act  could  not  be  made  and 
carried  up  lo  100  respirations  per  minute  without  such  con- 
centrated effort  that  ordinary  pain  c<  uld  make  no  impression 
upon  the  brain  while  this  abstraction  is  kept  up. 

Second.  There  is  a  specific  effecl  resulting  from  enforced 
respiration  of  100  lo  the  minute,  due  lo  the  ores*  of  en rboiiic 
iir'il  t/iix  xr{  free  jrtini -.tin  Hx.oiex.  generated  by  ibis  enforced 
normal  act  of  throwing  into  the  lungs  fire  time*  the  normal 
amount  of  oxygen  demanded  in  one  minute,  when  the  heart 
has  not  been  aroused  to  exalted  action,  which  conies  from 
violent  exercise  in  running  or  where  one  i-  suddenly  startled, 
which  excess  of  carbonic  acid  cannot  escape  in  the  same 
ratio  from  the  lungs,  since  the  heart  does  not  respond  to  the 
proportionate  overaction  of  the  lungs. 

Third.  Ilyperaemia  is  the  last  in  this  chain  of  effects, 
which  is  due  to  the  excessive  amount  of  air  passing  into  the 
hums  preventing  but  little  more  than  the  normal  quantity  of 
blood  from  passing  from  the  heart  into  the  arterial  circula- 
tion, but  damming  it  up  in  the  lira  in  with  its  ex  cos  of  carbonic- 
acid  gas  to  act  also  directly  upon  the  brain  as  well  as  through- 
out I  be  capillary  and  venous  system,  and  as  well  upon  the 
heart,  the  same  as  if  ii  were  suspended  in  that  gas  outside  the 
body. 

The-e  are  evident  to  the  senses  of  any  liberal  observer  who 
can  witness  a  subject  rapidly  breathing. 

Some  ask  why  is  not  this  same  thing  produced  when  one 
has  been  running  rapidly  for  a  few  minutes?  For  a  very 
good  reason:  in  this  case  the  rapid  inhalations  are  preceded 
by  the  violent  throes  of  (he  heart  to  propel  the  carbonized 
blood  from  the  overworked  tissues  and  have  them  set  free 
at  the  lungs  where  the  air  is  rushing  in  at  the  normal  ratio 
of  four  to  one.  Thi>  is  not  an  abnormal  action,  but  is  of 
necessity,  or  asphyxia  would  instantly  result  and  the  runner 
drop.  Such  sometimes  occurs  where  the  runner  exerts 
himself  too  violently  at  the  very  outset;  and  to  do  so  he 
is  compelled  to  hold  his  breath  for  this  undue  effort,  and  the 
heart  cannot  carry  the  blood  fast  enough.  In  this  instance 
there  is  an  approach  to  analgesia  as  from  rapid  breathing. 

Let  me  take  up  the  first  factor — dii'rrxinn  ofirill — and  show 
that  nature  invariably  resorts  to  a  sudden  inhalation  to  pre- 
sent sevi  re  infliction  of  pain  being  felt.  It  is  the  panacea 
to  childhood's  frequent  bruises  and  cuts,  -nid  every  one  will 
remember  how  when  a  tinner  has  be<  n  hurt  it  is  thrust  into 
the  mouth  and  a  violent  number  of  efforts al  rapid  inhalation 
is  effected  until  ease  comes.  By  others  it  is  subdued  by  a 
lit  of  crying,  which  if  you  will  but  imitate  the  sobs,  will  find 
how   frequently  the  respirations  are  made. 

One  is  startled,  and  the  heart  would  seem  to  jump  out  of 
the  ehesl ;  in  quick  obedience  to  nature  the  person  is  found 
making  a  number  of  quick  inhalations,  which  subdue  the 
heart  and    pacify  the  will  by  diversion  from  the  cause. 

The  same  thing  is  observed  in  the  lower  animals.  1  will 
relate  a   case : 

An  elephant  had  been  operated  upon  for  a  diseased  eye 
which  gave  him  great    pain,   for  which    he   was   unprepared. 


13 

and  he  was  wrathy  at  the  keeper  and  surgeon.  It  soon  passed 
off,  and  t lie  result  of  the  application  was  so  beneficial  to  the 
animal  that  when  brought  out  in  a  few  days  after,  to  have 
another  touch  of  caustic  to  the  part,  he  was  prepared  for 
them;  and.  just  before  the  touch,  he  inflated  the  lungs  to 
their  fullest  extent,  which  occupied  more  time  than  the  effect 
of  (he  caustic,  when  he  made  no  effort  at  resistance  and 
showed  no  manifestation  of  having  been  pained. 

In  many  cases  of  extraction  of  the  temporary  teeth  of  chil 
dren.  1  make  them  at  the  instant  1  grasp  the  tooth  take  one 
very  violent  inhalation,  which  is  sufficient.  Mesmeric  anaes- 
thesia can  well  be  classified  under  diversion  or  subjugation 
of  the  will,  but  can  he  effected  in  but  a  small  percentage  of 
the  cases.  To  rely  upon  this  first  or  primary  effect,  except  in 
instantaneous  cases,  would  be  failure. 

The  second  factor  is  the  one  upon  which  I  can  rely  in  such 
of  the  cases  as  come  into  my  care,  save  when  1  cannot  in- 
duce them  to  make  such  a  number  of  respirations  as  is  abso- 
lutely necessary.  The  \rhole  mcret  of  soccexs  lien  in  the ^great- 
est number  of  respiration- that  can  be  effected  in  from  00  to 
III)  seconds,  and  that  without  any  intermission.  If  the  heart, 
by  the  xloio  method  of  respiration,  is  pulsating  in  ratio  of  four 
to  one  respiration,  no  effect  run   lie  induced. 

When  the  respirations  are.  say,  100  to  the  minute,  and  made 
with  all  the  energy  the  patient  can  muster,  and  are  kept  up 
while  the  operation  is  going  on.  there  can  hardly  be  a  failure 
in  the  minor  operations. 

It  is  upon  this  point  many  of  you  may  question  the  fact-. 
Before  I  tried  it  for  the  first  lime  upon  my  own  person.  1 
arrived  at  the  same  conclusion  from  a  course  of  argument, 
that  rapid  breathing  would  control  the  heart's  action  and 
pacify  it.  and  even  reduce  it  below  the  normal  standard  un- 
der my  urgent  respirations. 

In  view  of  the  many  applications  made  1  feel  quite  sure 
in  my  belief  that,  inasmuch  as  the  heart's  action  i-  bul 
slightly  accelerated,  thoimh  with  less  force  from  rapid  breath- 
ins:  at  the  rate  of  100  to  the  minute,  (here  is  such  an  excess 
of  carbonic  acid  gas  set  free  and  crowding  upon  the  heart 
and  capillaries  of  the  brain,  without  a  chance  to  escape 
by  the  lungs,  that  it  is  the  same  to  ail  intents  as  were 
carbonic  acid  breathed  through  the  lung-  in  common  air. 
Look  at  the  result  after  this  has  been  kepi  up  for  a  minute 
or  more.  During  the  next  minute  the  respirations  are  not 
more  than  one  or  two.  and  the  heart  ha-  fallen  really  lie- 
low,  in  some  cases,  the  standard  bent,  showing  most  con- 
clusively that  once  oxygenation  has  taken  place  and  that  tin- 
free  carbonic  acid  gas  has  been  so  completely  consumed, 
there  is  no  involuntary  call  through  the  pneumogastric 
nerve  for  a  supply  of  oxygen. 

If  any  physiological  facts  can  be  proven  at  all.  then  1  feel 
quite  sure  of  your  verdict  upon  my  side. 

There  is  no  one  thing  that  goes  so  far  to  prove  the  theory 
of  Lavoisier  regarding  the  action  of  oxygen  in  the  tissues 
and  capillaries  for  converting  carbon  into  carbonic  acid  gas 
instead  of  the  lungs,  as  held  prior  to  that  time,  and  still  held 
by  many  who  are  not  posted  in  late  experiments.  At  the 
time  I  commenced  this  practice  I  must  confess  I  knew  noth- 
ing of  it.  The  study  of  my  cases  soon  led  me  to  the  same 
theory  of  Lavoisier,  as  1  could  not  make  the  phenomena 
agree  with  the  old  theory  of  carbonic  acid  generated  only 
in  the  lungs. 

When    Vierordt    was    performing  his    experiments  upon 


14 

himself  in  rapid  breathing  from  six  times  per  minute  to 
ninety-six,  I  cannot  understand  why  lie  failed  to  observe 
and  record  what  did  certainly  result — an  extreme  giddiness 
with  muscular  prostration  and  numbness  it*  the  peripheries 
of  the  hands  and  feet,  with  suffusion  of  the  face,  and  such 
a  loss  of  locomotion  as  to  prevent  standing  erect  without 
desiring  support.  Besides,  the  very  great  difference  he 
found  in  the  amount  of  carbonic  acid  retained  in  the  circu- 
culation,   the  very  cause  of  the  phenomena   just  spoken  of. 

One  thing  conies  in  just  here  to  account  for  the  lack  of 
respiration  the  minute  after  the  violent  effort.  The  residual 
air,  which  in  a  normal  state;  is  largely  charged  with  car- 
bonic acid,  has  been  so  completely  exhausted  that  some 
moments  are  consumed  before  there  is  sufficient  again  to 
call  upon  the  will  for  its  discharge. 

As  to  hypcncinia,  you  will  also  assent,  now  that  my 
second  factor  is  explained;  but  it  is  so  nearly  allied  to  the 
direct  effect  of  excessive  respiration  that  we  can  well  per- 
mit it  to  pass  without  argument.  If  hypencmia  in  present, 
we  have  a  more  certain  and  rather  more  lasting  effect. 

In  conclusion,  I  will  attempt  lo  prognosticate  the  applica- 
tion of  this  principle  to  the  cure  of  many  diseases  of  chronic 
nature,  and  especially  tuberculosis;  where  from  a  diminished 
amount  off  air  going  into  the  lungs  for  want  of  capacity,  and 
particularly  for  want  of  energy  and  inclination  to  breathe 
in  full  or  excess,  the  tissues  cannot  get  clear  of  their  excre 
mentitious  material,  and  particularly  the  carbon,  which 
must  go  to  the  lungs,  this  voluntary  effort  can  be  made'  fre 
quently  during  the  day  to  free  tin;  tissues  and  enable  them 
to  take  nutritious  material  for  their  restoration  to  their  stand- 
ard of  health. 

Air  will  be  found  of  far  more  value  than  ever  before  as  one 
of  the  greatest  of  factors  in  nutrition,  and  which  is  as  neces- 
sary as  proper  food,  and  without  which  every  organization 
must  become  diseased,  and  no  true  assimilation  can  take 
place  without  a  due  amount  of  oxygen  is  hourly  and  daily 
supplied  by  thi<  extra  aid  of  volition  which  has  been  so  long 
overlooked. 

The  pure  oxygen  treatment  has  certainly  performed  many 
cures;  yet.  when  compared  lo  the  mechanical  mixture  and 
under  tin- direct  control  of  the  will,  at  all  times  and  seasons, 
there  is  n<>  danger  from  excessive  oxygenation  as  where  pure 
oxygen  is  given.  When  every  patient  can  be  taught  to  rely 
upon  this  great  safety  valve. of  nature,  there  will  be  less  need 
for  medication,  and  the  longevity  of  mil'  race  be  increased  with 
bin  little  dread  by  mankind  of  that  terrible  monster  con 
sumption,  which  seems  to  have  now  unbounded  control. 

When  this  theory  I  have  here  given  you  to-night  is  fully 
comprehended  by  the  medical  world  and  taught  the  public. 
together  with  the  kind  of  foods  necessary  for  every  one  in 
their  respective  occupation,  location,  and  climate,  we  may 
expect  a  vast  change  in  their  physical  condition  and  a  hope 
for  the  future  which  will  brighten  as  lime  .advances. 

I  herewith  attach  the  sphygmographic  tracings  made  upon 
myself  by  another,  showing  the  state  of  the  pulse  as  compared 
■with  the  progress  of  the  respiration. 

ADDENDA. 

Sphygmographic  tracings  of  the  pulse  of  the  essayist. 
Normal  pulse  HO  to  the  minute.  Six  seconds  necessary  for 
the  slip  to  pass  under  the   instrument. 


15 


A. 


Jl 


-A_Jl_JY_Jl_JV_ 


3 


C 


7) 


^F 


'•-*rf\„. 


G 


A,  A1,  normal  pulse. 

B.  pulse  taken  after  breathing  rapidly  for  15  seconds  when 
20  respirations  had   been  taken 

0,   rapid  breathing  for  :{(')  second-.  4:!  respirations. 

r>.        "  •■  4.-»  rii      •■ 

K.,  "  "    (50         ■'        96 

F,  pulse  taken  after  rapid   breathing   for  one  minute,  as 
in  E,  where  no  respiration  had  as  yet   been  taken  after  the 


it; 


essayist  had  kept  it  up  for  that  one  minute.  This  was 
after  10  seconds  had  intervened. 

G,  the  same  taken  50  seconds  after,  and  still  no  respi- 
ration had  been  taken,  the  subject  having  no  disposition 
to  inhale,  the  blood  having  been  over  oxygenated. 

The  pulse  in  E  shows  after  96  respirations  but  14.  or  S4 
per  minute,   and   the   force  nearly  as  in  the  normal  at  A.  A1. 

The  record  in  1>  shows  the  force  more  markedly,  hut 
still   normal  in   number. 

F  and  G  show  very  marked  diminution  in  the  force, 
but  the  number  of  pulsations  not  over  72  per  minute;  G 
particularly  so,  tin;  heart  needing  the  stimulus  of  the  oxy- 
gen for  full  power. 

The  following  incident  which  has  but  very  recently  been 
made  known,  gives  most  conclusive  evidence  of  the  truth 
of  the  theory  and   practice  of  rapid  breathing. 

A  Mexican  went  into  the  office  of  a  dentist  in  one  of 
I  he  Mexican  cities  to  have  a  tooth  extracted  by  nitrous 
oxide  gas. 

The  dentist  was  not  in,  and  the  assistant  was  about  to 
permit  the  patient  to  leave  without  removing  the  tooth, 
when  the  wife  of  the  proprietor  exclaimed  that  she  had 
ofti  n  assisted  her  husband  in  giving  the  Lias,  and  that  she 
would  do  so  in  this  instance  if  the  assistant  would  extract 
the  tooth.  It  was  agreed.  All  being  in  readiness,  the 
lady  turned  on,  as  she  supposed,  the  iras.  and  the  Mexican 
patient  was  ordered  to  breathe  as  fast  as  possible  to  make 
sure  of  the  full  effect  and  no  doubt  of  the  final  success.  The 
assistant  was  about  to  extract,  but  the  wife  insisted  on  his 
breathing  more  rapidly,  whereupon  the  patient  was  observed 
to  become  very  dark  or  purple  in  the  face,  which  satisfied 
the  lady  that  the  full  effect  was  manifested,  and  the  tooth 
was  extracted,  to  the  great  satisfaction  of  all  concerned. 
While  the  gas  was  being  taken  by  the  Mexican  the  gasome- 
ter was  noticed  to  rise  higher  and  higher  as  the  patient 
breathed  faster,  and  not  to  sink  as  was  usual  when  the  gas 
had  been  previously  administered.  This  led  to  an  invest] 
gation  of  the  reason  of  such  an  anomalous  result,  when  to 
their  utter  surprise  they  found  the  valve  was  so  turned  by 
the  wife  that  the  Mexican  had  been  breathing  nothing  but 
common  air,  and  instead  of  exhaling  into  the  surrounding 
air  he  violently  forced  it  into  the  gasometer  with  the  nitrous 
oxide  gas.  causing  it  to  rise  and  not  sink,  which  it  should 
have  done  had  the  valve  been  properly  turned  for  the  pas- 
age  of  gas  into  the  lungs  of  the  patient. 

No  more  beautiful  and  positive  trial  could  happen,  and 
might  not  again  by  accident  or  inadvi  rtence  happen  again 
in  a    lifetime. 

A  similar  case  was  related  to  me,  by  the  dentist  in  charge. 
which  happened  in  Arlington,  Del.,  but  he  could  not,  as  in 
the  case  of  the  Mexican,  understand  why  it  was  so. 


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